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You will be radioactive for several days after radioactive iodine treatment. You will be able to go home from hospital when the radiation level in your body is at a safe level.
You may still have to take some precautions when you go home. Your healthcare team will explain everything to you.
They will also tell you about the side effects. These vary depending on:
You will need to take thyroxine tablets. These replace the hormones that your thyroid gland normally makes. Your doctors will want to keep your thyroid hormone levels slightly higher than normal. This is to stop your body producing another hormone (thyroid stimulating hormone, or TSH). TSH can help some types of thyroid cancer cells to grow.
The doctors will work out the correct dose for you and when to start taking it.
You need to follow safety precautions for a few days after your treatment. This is to protect others from the radiation.
The advice about precautions varies for different people and for different hospitals. Talk to your doctor, specialist nurse or medical physicist. They will explain how long you need to limit yourself.
These precautions include:
Stay away from crowded places and avoid using public transport. If you live or work with other people, you will need to keep a distance from them. Avoid standing or sitting close to them. This stops them from getting radiation from you.
Your doctor will tell you not to have close, lengthy contact with others for a couple of weeks. This includes babies, young children, pets and pregnant women. Avoid hugging and kissing other people.
You might need to sleep in a separate bed if you normally share a bed. Check if this applies to you and ask how long this should be for.
You might need to avoid sexual intercourse for a period of time or to use a condom. Check if this applies to you and ask how long this should be for.
It is also recommended that:
A small amount of radiation will still be in your sweat, urine and saliva. For a few weeks you will need to use your own towel and keep your cutlery and plates away from others until washed. Continue to flush the toilet twice and wash your hands thoroughly after using the toilet.
Recent treatment with radioactive iodine may set off radiation alarms at airports. Talk to you doctor if you plan to travel abroad. You can have a certificate from the hospital, or a letter from your doctor. This explains the treatment you have had.
The side effects of radioactive iodine treatment vary depending on:
Some people may have one or more of the following short term side effects:
Your salivary glands can become inflamed after treatment. This can cause symptoms such as swelling and pain. You can have painkillers to help with the inflammation.
You may make less saliva (spit) and feel like your mouth is dry. This usually gets better with time, but in a few people it may be permanent.
To reduce the risk of getting this side effect, it can help to drink plenty of fluids during your hospital stay. Some doctors recommend that you chew gum or suck sweets to keep the salivary glands working. If you have a dry mouth, you could try using artificial saliva to see if this helps. Your doctor or nurse can arrange this for you.
You may have short term changes to your taste and smell. This may not start until you get home. It usually gets better within 4 to 8 weeks. It can help to drink plenty of fluids after your treatment.
Some people may have a feeling of tightness or swelling in their neck for a few days after treatment. This is more common if you still had a large part of your thyroid gland. Some people also feel flushed. Rarely, people can feel pain in their neck.
Tell your doctor or nurse if any of these symptoms happen. They can give you a painkiller or a medicine to reduce inflammation, which can help.
You may feel sick for the first few days after treatment. Your doctor or nurse can give you anti sickness medicine to help with this.
The treatment can inflame the lining of your tummy or bladder.
Symptoms of an inflamed tummy (gastritis) include:
Symptoms of bladder inflammation (cystitis) include:
Talk to one of your team if you have any of these side effects.
Possible long term side effects include:
Radioactive iodine treatment should not affect your ability to have children, even if you need to have repeated treatments.
Some men need to have more than one treatment with radioactive iodine. After repeated treatments they may have lower sperm counts and lower testosterone levels. This usually gets better with time. Rarely, it means that you may be unable to father a child (be infertile). Your doctor may offer you sperm banking before you start treatment.
After treatment, doctors usually recommend you wait before you try to conceive a baby. Women should wait for at least 6 months and men for at least 4 months. Doctors feel that there is less risk of the radiation affecting a pregnancy after this time.
For a few people, inflammation of the salivary glands can be a long term problem. This may cause a dry mouth and changes in taste and smell.
It is common for people to feel very tired for up to a year after treatment. But energy levels will usually return to normal levels. Most people get back to leading a normal life.
Radioactive iodine treatment can sometimes affect the lacrimal glands. These are glands in your eyes which make tears. Rarely, some people develop dry eyes and some people get watery eyes.
Contact us to discuss your requirements of I-131 radiotherapy. Our experienced sales team can help you identify the options that best suit your needs.
Bone marrow is the spongy substance in the centre of the bones. It makes red and white blood cells and platelets. Radioactive iodine treatment can sometime affect the bone marrow. This can cause a small drop in the number of blood cells. This usually doesn’t last long and should cause no problems.
You might also have external radiotherapy if the cancer has spread to your bones. Having both treatments can cause a drop in the number of blood cells. If this happens you may have lower resistance to infection, tiredness and breathlessness. Or you may notice that you bruise or bleed more easily. You may need to have blood tests to monitor your blood cell levels. It is rare for this to be a long term problem after radioactive iodine treatment.
You might need to repeat radioactive iodine treatment if thyroid cancer has spread to your lungs. Very rarely, you may develop problems with your lungs.
The treatment makes the lung tissue less stretchy. This is called radiation fibrosis and it can make it harder to breathe. Your doctors will keep an eye on your lung function.
After this treatment, you may have a slightly increased risk of developing a second cancer in the future. Doctors are not sure exactly how much your risk is increased. But most studies suggest it is a very low increase in risk.
Your doctor or nurse specialist will discuss this with you if you are worried. They can help you weigh up this risk with the benefit of treating the thyroid cancer.
Some people might need more than one radioactive iodine treatment. This is to make sure the treatment destroys all the remaining thyroid tissue and cancer cells.
During the Cold War in the mid-1940s through early 1960s, the U.S. government conducted about 100 nuclear weapons (atomic bomb) tests in the atmosphere at a test site in Nevada, more than 100 in the Pacific, and one—the first ever—in New Mexico. The radioactive substances released by these tests are known as "fallout." They were carried thousands of miles away from the test site by winds. As a result, people living in the United States at the time of the testing were exposed to varying levels of radiation.
Among the numerous radioactive substances released in fallout, there has been a great deal of concern about and study of one radioactive form of iodine--called iodine-131, or I-131. I-131 collects in the thyroid gland. People exposed to I-131, especially during childhood, may have an increased risk of thyroid disease, including thyroid cancer. Thyroid cancer is uncommon and is usually curable. Typically, it is a slow-growing cancer that is highly treatable. About 98 out of 100 people who are diagnosed with thyroid cancer survive the disease for at least five years after diagnosis.
The thyroid controls many body processes, including heart rate, blood pressure, and body temperature, as well as childhood growth and development. It is located in the front of the neck, just above the top of the breastbone and overlying the windpipe.
Although the potential of developing thyroid cancer from exposure to I-131 from nuclear weapons testing is small, it is important for Americans who grew up during the atomic bomb testing between 1945 and 1963 to be aware of risks.
Because of wind and rainfall patterns, the distribution of I-131 fallout varied widely after each test. Therefore, although all areas of the United States received fallout from at least one nuclear weapons test, certain areas of North America received more fallout than others.
Scientists estimate that the larger amounts of I-131 from the Nevada test site fell over some parts of Utah, Colorado, Idaho, Nevada, and Montana. But I-131 traveled to all states, particularly those in the Midwestern, Eastern, and Northeastern United States. Some of the I-131 collected on pastures and on grasses. Depending on the location, grazing cows and goats sometimes consumed contaminated grasses resulting in I-131 collecting in the animals' milk. Much of the health risk associated with I-131 occurred among milk-drinkers--usually children. From what is known about thyroid cancer and radiation, scientists think that people who were children during the period of atomic bomb testing are at higher risk for developing thyroid cancer.
In addition to nuclear testing in Nevada, the Pacific, and New Mexico, Americans were potentially exposed to I-131 from a number of events, including:
Scientists are working to find out more about ways to measure and address potential I-131 exposure. They are also working to find out more about other radioactive substances released by fallout and their possible effects on human health.
Congress directed government health agencies to investigate the I-131 problem many years ago, and to make recommendations to Americans who might have related health risks. Gathering information turned out to be very complicated. Record-keeping was incomplete at the time of the bomb testing. Much of the information needed to calculate an individual's dose of I-131 and associated risk is either unreliable or unavailable.
Despite such challenges, government agencies organized expert scientific teams that have devoted many years to learning more about I-131. A number of reports have been published documenting what they have learned (1997, 1999). This information was put together to educate the American people about the potential health risks from exposure to I-131 from nuclear weapons testing.
The "active" in "radioactive" means that unstable substances produced in nuclear reactions break down and change, so that they eventually become stable and no longer release radiation. The rate of breakdown can occur quickly in some radioactive substances, often within a few days. Half of the I-131 released during each atomic bomb test was gone in about 8 days. Almost all of it was gone (less than 1 percent remained) 80 days after the test.
Like all radioactive substances, I-131 releases radiation as it breaks down. It is this radiation that can injure human tissues. But I-131's steady breakdown means that the amount of I-131 present in the environment after a bomb test steadily decreased. Therefore, farm animals that grazed in fields within a few days after a test would have consumed higher levels of I-131 than animals grazing later.
People younger than 15 at the time of aboveground testing (between 1945 and 1963) who drank milk, and who lived in the Mountain West, Midwestern, Eastern, and Northeastern United States, probably have a higher thyroid cancer risk from exposure to I-131 in fallout than people who lived in other parts of the United States, who were over the age of 15 in the 1940s, or who did not drink milk. Their thyroid glands were still developing during the testing period. And they were more likely to have consumed milk contaminated with I-131. The amount of I-131 people absorbed depends on:
Age and residence during those years are usually known. But few people can recall the exact amounts or sources of the milk they drank as children. While the amount of milk consumed is important in determining exposure to I-131, it is also important to know the source of the milk. Fresh milk from backyard or farm cows and goats usually contained more I-131 than store-bought milk. This is because processing and shipping milk allowed more time for the I-131 to break down.
There are two main types of thyroid diseases:
Noncancerous Thyroid Disease
Some thyroid diseases are caused by changes in the amount of thyroid hormones that enter the body from the thyroid gland. Doctors can screen for these with a simple blood test.
Noncancerous thyroid disease also includes lumps, or nodules, in the thyroid gland that are benign and not cancerous.
Thyroid Cancer
Thyroid cancer occurs when a lump, or nodule, in the thyroid gland is cancerous.
Thyroid cancer accounts for a little less than 4 percent of all cancers diagnosed in the United States. Incidence has been going up in recent years, in part due to increased detection. Researchers suspect that rising rates of obesity are also influencing rates. However, these two factors do not fully explain the increases. Typically, thyroid cancer is slow-growing, highly treatable, and usually curable. About 98 out of 100 people who are diagnosed with thyroid cancer survive the disease for at least five years, and about 92 out of 100 people survive the disease for at least 20 years after diagnosis.
The cause of most cases of thyroid cancer is not known. Exposure to I-131 can increase the risk of thyroid cancer. It is thought that risk is higher for people who have had multiple exposures and for people exposed at a younger age. But even among people who have documented exposures to I-131, few develop this cancer. It is known that children have a higher-than-average risk of developing thyroid cancer many years later if they were exposed to radiation. This knowledge comes from studies of people exposed to x-ray treatments for childhood cancer or noncancerous head and neck conditions, or as a result of direct radiation from the atomic bombings of Hiroshima and Nagasaki.
The thyroid gland in adults, however, appears to be more resistant to the effects of radiation. There appears to be little risk of developing thyroid cancer from exposure to I-131 or other radiation sources as an adult.
For more on thyroid cancer, see NCI’s Thyroid Cancer page.
How can people reach a sound decision about their risk of thyroid cancer? When is it time to visit a doctor?
A "personal risk profile" includes four key points that may influence a person's decision to visit a doctor or other health professional for evaluation:
Scientists know that:
Reliable information about I-131's impact on human health has been difficult to collect, but scientists think that:
Key steps to estimating personal risk of thyroid cancer, and taking charge of personal thyroid health include:
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